NPI | 1578924163 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9432059) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 33340469) |
Enumeration Date | 2016-03-10 |
Last Update Date | 2023-03-07 |